Preeclampsia

Preeclampsia is a dangerous condition that occurs in 5 to 8 percent of all pregnancies, and is characterized by high blood pressure and the presence of protein in the urine. Also known as toxemia, preeclampsia and other hypertensive disorders of pregnancy are a leading cause of maternal and infant illness and death, responsible for 76,000 deaths each year according to conservative estimates.

The elevated blood pressure associated with preeclampsia can reduce the supply of blood to many of your organs, including the placenta, which can deprive your baby of essential oxygen and nutrients, which in turn can cause placental abruption, low amniotic fluid levels, and poor fetal growth. Preeclampsia usually occurs after the 20th week of the pregnancy and symptoms include swelling, sudden weight gain, headaches, and changes in vision. However, some women with rapidly advancing preeclampsia have few or very mild symptoms.

Although the precise cause of preeclampsia is not known, it often occurs in women during their first pregnancy, those carrying multiple babies, those with a close relative who developed preeclampsia, obese women, those with chronic hypertension or certain blood clotting disorders, and in women under 20 or over 40.

If you are at risk, your doctor may recommend you take a baby aspirin every day during your pregnancy as a preventative measure. In addition, resting on your left side helps your kidneys function efficiently and allows blood to flow more freely to your placenta.

Unfortunately, there is no single test for preeclampsia. Your doctor will check your blood pressure, weight, and urine at every prenatal appointment to look for signs of the disorder. If you do develop preeclampsia, treatment will depend on the severity of your condition and how far along you are. If it is too early to deliver your baby safely, and you have a mild case of preeclampsia, your doctor will probably prescribe bedrest, plenty of fluids, and medication to help lower your blood pressure, increase uterine blood flow, and prevent seizures. However, if your preeclampsia is more severe, you may be admitted to the hospital for bedrest and monitoring.

Your doctor will perform non-stress tests, contraction stress tests, or biophysical profiles to check on your baby, and ultrasounds will be used to monitor the amount of amniotic fluid in your uterus. If that level falls too low, or if your caregiver has any other reason to suspect that your baby isn't getting an adequate blood supply, he or she will induce labor or perform a c-section as soon as your baby's lungs are mature enough. Even if your baby's lungs are not fully developed, your doctor may choose to induce labor if your health is jeopardized due to kidney or liver damage, bleeding, or seizures.

After delivery, you will be monitored closely for a few days to make sure your blood pressure drops and to watch for signs of other complications, such as eclampsia (seizures) and HELLP syndrome. Most women's blood pressure begins to drop a day or so after delivery, especially those with mild preeclampsia; while more severe cases may remain elevated for longer. These women are often given magnesium sulfate through an IV for at least 24 hours after delivery to help prevent seizures, and may end up going home on blood pressure medication.

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